Supervisor Professional Coding

FLSA Status

Job Role Summary

The Supervisor, Professional Coding is responsible for supervising and responding to questions from the coding team, investigating responses to ensure compliance, and following medical policy and all other governmental rules and regulations for both facility and professional services. This position updates UKG assists with hiring new team members and progressive discipline for existing team members.  Proactively contributes to Eskenazi Health’s mission: Advocate, Care, Teach and Serve with special emphasis on the vulnerable population of Marion County; models Eskenazi Health values.

Essential Functions and Responsibilities

•    Coding and Abstracting: Identifies and assigns the appropriate diagnosis, procedure, and evaluation and management (E&M) codes in accordance with coding guidelines and departmental standards; delivers provider education to new and existing providers. 
•    Keeps providers and management updated on new policy regulations and coding issues as well as suggestions to improve workflow and processes to ensure compliance with all regulations; audits notes from providers to ensure the provider is coding in a compliant manner according to governmental rules and regulations; provides feedback to the provider if there are any questions or concerns; meets with providers face-to-face to review documentation and coding guidelines as necessary. 
•    Keeps management in the loop for providers not responding to or maintaining adequate compliance results; audits coding team to ensure they are meeting compliance and governmental rules and regulations, bringing concerns to management’s attention; meets/exceeds departmental standards of performance related to productivity and quality standards
•    Charge Entry:  Captures charges accurately based on documentation and medical necessity, and integrates charges and codes appropriately for professional and facility services; makes suggestions for additions to the fee schedules based upon recognition of new procedures and/or supplies
•    Problem Solving:  Utilizes available resources appropriately to maintain quality and consistency in coding, abstraction, and charge entry processes; follows a defined process to query the medical staff for completion and/or clarification of documentation necessary to ensure coding compliance and accuracy
•    Medical Necessity:  Recognizes cases that require specific medical necessity coverage diagnoses; applies Local Coverage Determination (LCD) policies as necessary
•    Brings any concerns/issues to management’s attention with examples within the same date of discovery
•    Stays current with all medical policy updates for carriers; assists with getting the updated information out to the team members; ensures any changes that require system adjustments are brought to management’s attention quickly so Epic build/adjustments can occur
•    Identifies more efficient and appropriate ways to ensure clean claims are going out the first time
•    Acts as a role model to the team, demonstrating a positive attitude toward management and leadership decisions 
•    Assists Accounts Receivable Specialists with questions and concerns to ensure claims are compliant and accurate for submission and payment
•    Assists with training of new team members
 

Job Requirements

•    High School diploma or equivalent required
•    CCS-P or CPC certification required
•    Assoc/bachelor’s degree preferred
•    Five years prior coding experience in physician and/or mental health physician office/hospital setting
•    Epic experience a plus
•    Dental, vision and/or DME coding a plus
•    Experience in an FQHC/CCBHC setting a plus (preferred)